膝关节半月板囊肿的微创治疗

Minimally invasive treatment of knee meniscal cyst

[目的]探讨膝关节半月板囊肿的微创治疗方法。[方法]2009年1月~2014年12月,对36例膝关节半月板囊肿行关节镜下囊肿切除,硬膜外穿刺针引导2号骨科缝线由外向内缝合消除囊肿的残腔,皮外的缝线用硬膜外穿刺针引导至一个针孔,皮下打结。[结果]36例患者获得随访,随访时间2~7年,无1例囊肿复发,按国际膝关节评分委员会(IKDC)膝关节功能评分,手术前为(69.7±3.8)分,末次随访为(96.5±4.2)分,36例结果均为优。[结论]关节镜下囊肿切除、硬膜外穿刺针引导骨科缝线微创治疗半月板囊肿治疗效果满意,不仅去除了囊肿,还保留了半月板结构,从而减少了继发性骨性关节炎的风险。

[Objective] To investigate the clinical outcome of minimally invasive treatment of knee joint meniscus cyst. [Method] From January 2009 to December 2014, 36 patients with meniscal cyst received the minimally invasive Surgery. The meniscal cysts were excised with shaver under arthroscopy, and then the residual cavity of the cyst was eliminated with No.2 suture outside-in guided by epidural puncture needle. Subsequently free ends of the suture outside skin was introduced in- to subcutaneous layer with epidural needle, and knotted subcutaneously. [Results] All 36 patients were followed up for 2 to 7 years with an average of 4 years. No recurrence was found in any patient during follow-up. IKDC score improved significantly from （69.7＋_3.8） preoperatively to （96.5＋_4.2） at the latest follow up. The results in all of the 36 cases were graded as excel- lent. [ Conclusion] For knee meniscal cyst, this minimally invasive treatment not only removes the cyst and eliminate the residual cavity, but also preserve meniscal structure associated with satisfactory clinical outcome, which implies reduced risk of secondary osteoarthritis.